Creating a Common Creating a Common Operating PictureOperating Picture

Eddie Oldfield, BA, Candidate M.Phil (policy)Eddie Oldfield, BA, Candidate M.Phil (policy)

Director, NB Climate Change Hub and Director, NB Climate Change Hub and Environmental Health Mapping, New Brunswick Environmental Health Mapping, New Brunswick

Lung AssociationLung Association

May 2010May 2010

Public Health ApplicationsPublic Health ApplicationsThe “Learning from SARS” report, by the National Advisory Committee on SARS The “Learning from SARS” report, by the National Advisory Committee on SARS

and Public Health, identified many systemic deficiencies in responding to SARS in and Public Health, identified many systemic deficiencies in responding to SARS in

Canada. Among these were: absence of protocols for sharing data, poor Canada. Among these were: absence of protocols for sharing data, poor

coordination among health authorities at national, provincial, and local levels, coordination among health authorities at national, provincial, and local levels,

delays in identification of unknown virus, poor understanding of disease etiology delays in identification of unknown virus, poor understanding of disease etiology

and transmission vectors. and transmission vectors.

GIS for Public Health in GIS for Public Health in CanadaCanada• Nearly a decade has passed since the first call to integrate GIS Nearly a decade has passed since the first call to integrate GIS

technology into the Canadian health-care planning process.technology into the Canadian health-care planning process.

• Conversely, GIS applications have become a staple in European Conversely, GIS applications have become a staple in European health policy evaluation tools:health policy evaluation tools:

– a national public health atlas in The Netherlands, a national public health atlas in The Netherlands,

– healthcare planning tools in Switzerland, and healthcare planning tools in Switzerland, and

– modular GIS applications in the United Kingdom. modular GIS applications in the United Kingdom.

• The expansion of the Canadian Geospatial Data Infrastructure The expansion of the Canadian Geospatial Data Infrastructure into the public health discipline is deemed critical into the public health discipline is deemed critical for addressing for addressing shortcomings in population health monitoring, developing effective shortcomings in population health monitoring, developing effective intervention strategies for intervention strategies for chronic and infectious diseasechronic and infectious disease, improving , improving healthcare services,healthcare services, and responding to health and safety and responding to health and safety emergenciesemergencies. NB Lung carried out analysis for GeoConnections on . NB Lung carried out analysis for GeoConnections on gaps/opportunities for the CGDI in support of public health decision-gaps/opportunities for the CGDI in support of public health decision-making.making.

GIS Applications in support of Public GIS Applications in support of Public HealthHealth

Monitor epidemic outbreaks (influenza), communicable disease clusters, and Monitor epidemic outbreaks (influenza), communicable disease clusters, and

disease vectors (e.g. migratory bird routes, zoonotic vectors)disease vectors (e.g. migratory bird routes, zoonotic vectors)

Syndromic/surveillance/outbreak/adverse event detectionSyndromic/surveillance/outbreak/adverse event detection

Aboriginal health status (Tuberculosis, Diabetes etc)Aboriginal health status (Tuberculosis, Diabetes etc)

Monitor chronic diseases (including obesity)Monitor chronic diseases (including obesity)

Monitor water (including well-water) and food qualityMonitor water (including well-water) and food quality

Cross-disciplinary research (such as linking air quality, climate change and Cross-disciplinary research (such as linking air quality, climate change and

human health)human health)

Population demographics (for assessing population vulnerabilities)Population demographics (for assessing population vulnerabilities)

Joint health and safety emergency managementJoint health and safety emergency management

Highway safety / Weather-related incidentsHighway safety / Weather-related incidents

Public Health Infrastructure / facilitiesPublic Health Infrastructure / facilities

Ambulance vehicle routingAmbulance vehicle routing

All respiratory diseasesAll respiratory diseases

Global Warming – health impacts modeling (past, current, future scenarios)Global Warming – health impacts modeling (past, current, future scenarios)

Flood zones and Sea-Level Rise / Coastal ErosionFlood zones and Sea-Level Rise / Coastal Erosion

Emergency equipment locationsEmergency equipment locations

Enhance upon health data standardsEnhance upon health data standards

Build on-line health repositories (for public education)Build on-line health repositories (for public education)

Gaps in GIS for Public Gaps in GIS for Public HealthHealth·        Cost – equipment, software, data, staff, etc·        Cost – equipment, software, data, staff, etc

·        Concerns over data privacy ·        Concerns over data privacy

·        Lack of knowledge / training / competencies in GIS·        Lack of knowledge / training / competencies in GIS

·        Continuous need to educate decision-makers·        Continuous need to educate decision-makers

·        Uneven capacity among health authorities ·        Uneven capacity among health authorities

·        Barriers to integration of health data within CGDI ·        Barriers to integration of health data within CGDI

(e.g. (e.g.

health data standards / inconsistencies across health data standards / inconsistencies across

borders)borders)

·        Patchwork of applications, systems, standards·        Patchwork of applications, systems, standards

·        Patchwork research agenda (national) ·        Patchwork research agenda (national)

Mapping Public Health Mapping Public Health DataData

Access to Health Care

0 50 10025

Kilometers

Admission / 10,000 Population

00.1 - 7.17.1 - 9.79.7 - 15.715.7 - 110.3

Community Health Maps

Asthma Admission / 10,000 Population – 2001

Mapping Influenza Cases

0 50 10025

Kilometers

00.1 - 7.17.1 - 9.79.7 - 15.715.7 - 110.3

This project deals primarily with seamless integration of public health data, as discussed in the next slide.

From Data to MapsFrom Data to Maps• Data Licenses Obtained (Maine, NB, Canada)

• Data privacy is maintained at all times

• Application is Permission Based

• Historical Influenza Maps

• Simulated Pandemic Influenza Maps Incidence Frequency and Sum, 4 Health Outcomes, by 5 Age Groups, by Gender, by Day (550,000 reported cases)

• Multiple Geographic Scales: Dissemination Area, Census Area, Health Region, Province / State

• Infrastructure Data: Hospitals/Clinics, Schools, Roads, Administrative Boundaries, Exercise Operation Facility Locations

• Food and Fuel Supply

• School Absenteeism / Surveillance Data

• Medicine Supply / End-to-End Tracking

Mapping MethodsMapping Methods

• Cell distributionCell distribution– Frequency, Frequency,

cumulative, cumulative, Normative Normative distribution distribution methodsmethods

– Four geolayers: Four geolayers: Province, Health Province, Health Region, County, Region, County, Dissemination AreaDissemination Area

• Contour Contour distributiondistribution– Inverse Distance Inverse Distance

Weighting methodWeighting method– One geolayer: One geolayer:

Province/State; Province/State; with 4 boundary with 4 boundary overlays (Health overlays (Health Region, County, Region, County, Metropolitan, and Metropolitan, and DAUID levels)DAUID levels)

Mapping MethodsMapping Methods

Mapping Across BordersVisualization of Indicators in Space and Time

Examples of COMMON OPERATING PICTURES in Public Health:

WHO Protocol – Early Action Measures for Disease Containment

Contact Tracing – cluster outbreaks

Continuity of Operations

Protection of Critical Infrastructure (food, fuel, electricity, transport, industry, public security) through EAC

Public Health Resource Management

Reducing Public Exposure to Health Threats, natural and man-made disasters

Vaccine/Resource Distribution

Cancer, Respiratory, Heart/Stroke, and population health Research

Creating a COP in Public HealthCreating a COP in Public Health

Sharing Map Views / POIsSharing Map Views / POIs

Surveillance

Alerts

Feeds

Groups

Reports

- Phase 4 Alert – H1N1 activity in NB.- H1N1 Activity High in North East NB.- Fredericton School District reports high absenteeism / nurse visits.- Border restrictions activated at St-Stephen-Calais crossing…

Porting an existing desktop web application

Prototype Thin Client in Action

Map View

Data Entry

Layered windows

Wireless and Remote ApplicationsWireless and Remote Applications

Chief Medical Officer

Physician / Nurse / RT

Data Technician

Lab Verification of Suspected Cases

Ambulatory Response

Public Access

Must be easy to use

Notification

2007